| چکیده انگلیسی مقاله |
Background: One of the most effective treatments for patients with acute ischemic stroke (AIS) is intravenous recombinant tissue plasminogen activator (rtPA) which can minimize mortality and morbidities. In this historical cohort study, we investigate the factors affecting clinical outcomes after IV thrombolysis for AIS.
Methods: We included 87 patients with acute ischemic stroke who were treated with rtPA between 2015 and 2019. Demographic and clinical data were recorded. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the clinical outcomes.
Results: 36 patients showed lack of improvement at discharge. In unadjusted model, hypercholesterolemia was the only predictor of lack of improvement (P= 0.043; OR=0.304; CI= 0.096-0.963). After adjusting, hypertension (P= 0.018; OR= 0.18; CI= 0.043-0.749) and hypercholesterolemia (P= 0.008; OR= 8.68; CI= 1.773-42.54) were independent determinants of lack of clinical response. To evaluate risk factors in association with the duration of hospitalization, we found variables which lengthened hospitalization span including; age over 60 years (HR= 0.42 P= 0.002), hypercholesterolemia (HR= 2.19 P= 0.031), Angiotensin-converting enzyme (ACE) Inhibitors consumption (HR= 1.87 P= 0.022), and type of infarction (non-lacunar) (HR= 0.51 P= 0.026). Results indicated no considerable relationship between dose of rtPA and the appropriate response to treatment (OR=8.686 P= 0.324).
Conclusion: The closer dose of rtPA goes up to standard range, the more chance of improvement will gain without increasing the risk of symptomatic intra-cerebral hemorrhage (SICH). Determining factors involved in intravenous reperfusion outcomes help physicians to identify the patients who benefit the most from rtPA.
|
| نویسندگان مقاله |
| Seyed mohammad Masood Hojjati
Department of Neurology, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran
| Amir Hossein Hasanpour
Student Research Committee, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran
| Hoda Naghshineh
Mobility Impairment Research Centre, Health Research Institute Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| Ali Alizadeh khatir
Mobility Impairment Research Centre, Health Research Institute Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| Payam Saadat
Mobility Impairment Research Centre, Health Research Institute Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| Fatemeh Sahebian
Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran
| Rahele Mehraeen
Department of Radiology, Shahid Beheshti Hospital, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran
| Hoda Shirafkan
Social Determinants of Health Research c=Center, Health Research Institute, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran
|